Kamau Edwin, Ranson Elizabeth L, Tsan Allison T, Bergmann-Leitner Elke S, Garner Omai B, Yang Shangxin
Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, United States.
Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA, United States.
Front Microbiol. 2022 Oct 14;13:1001169. doi: 10.3389/fmicb.2022.1001169. eCollection 2022.
Hypervirulent (hvKp) is more invasive and virulent than classical , and requires specialized treatment. To raise clinical awareness, this study determined the prevalence, clinical characteristics, and genomic epidemiology of hvKp infections in Southern California (SoCal) by conducting a passive surveillance in a single large academic medical center. We report here that hvKp infections were more common than expected, accounting for 2.6% of invasive infections, and presented with a wide disease spectrum, occasionally mimicking tumors, even co-infecting a COVID-19 patient. Most infections were community acquired with no recent international travel, suggesting hvKp strains are circulating in the community. Genomic analysis revealed genetic diversity, with the K1-ST23 lineage predominating but not clonal, and multiple sequence types of K2 including a SoCal unique K2-ST66 sublineage that had been unrecognized. Our findings highlight the urgency of heightened awareness of hvKp infection in the US, the need for rapid diagnosis of hvKp, and the necessity of implementing robust surveillance programs for hvKp at the institutional or local level.
高毒力肺炎克雷伯菌（hvKp）比经典型更具侵袭性和毒力，需要特殊治疗。为提高临床认识，本研究通过在一家大型学术医疗中心进行被动监测，确定了南加州（SoCal）hvKp感染的患病率、临床特征和基因组流行病学。我们在此报告，hvKp感染比预期更常见，占侵袭性感染的2.6%，呈现出广泛的疾病谱，偶尔会模仿肿瘤，甚至与一名新冠肺炎患者合并感染。大多数感染是社区获得性的，近期无国际旅行史，这表明hvKp菌株在社区中传播。基因组分析显示出遗传多样性，K1-ST23谱系占主导但非克隆性，K2有多种序列类型，包括一个未被识别的SoCal独特的K2-ST66亚谱系。我们的研究结果凸显了在美国提高对hvKp感染认识的紧迫性、快速诊断hvKp的必要性以及在机构或地方层面实施针对hvKp的强有力监测计划的必要性。
